Switching from Anesthesia to EM

[Med!cineMan]

Putting feelers out to see if anyone has done this and what their experience has been? Current PGY2 Anesthesia resident, was torn between Anesthesia and EM so interviewed and applied both. Ranked Anesthesia higher, matched to a great program. Realize now that I miss the teamwork, diagnostics, patient interaction, and medicine of the ED vs being on my own in the OR for hours on end. And I have zero interest in supervising CRNAs in the future and giving up a lot of the clinical work. I've considered a CC fellowship, but not sure if I'd really want to spend my non OR time in the ICU. I enjoy critical care, but think I'd get my fill in the ED. I know it's not very common for people to switch out of Anesthesia, as it is a great field, and I do love the skillet that I'm getting from it. Just realizing more that I don't think it's the right fit for me. Has anyone made this switch and happy? My hesitancy is the long term sustainability of the wonky schedule, but I usually have no problem sleeping/working odd hours. Thanks in advance.

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[CopaceticOne]

Middle of CA-1 year can be the roughest time in residency.

Couple of things:
1) Have you talked to your PD / APD / advisor? Having the support of the program to endorse your switch will be very important.
2) Since you're a CA-1, what sub-specialties have you done so far? Don't forget that there is also pain and pre-op clinic stuff that could fill in the voids.
3) There are still MD only practices in more places than you would expect. Also working with trainees after you finish would keep your skills up for certain.
4) Are you sure you want to deal will all of the social issues that come with being an EM physician? Frequent flyers, 2 am ED visits for non-specific toe pain that has been there for 3 years, etc.
5) What about the current trend of supervising PAs / NPs who do the majority of staffing in some EDs - would you be ok with being responsible for their choices in treating patients? And would you be ok with production pressures to see and dispo "X" number of patients per hour?